Scars and perforator-based flaps in the abdominal region: A contraindication?

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Adrian Dragu - , Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)
  • Frank Unglaub - , Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)
  • Maya B. Wolf - , Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)
  • Justus P. Beier - , Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)
  • Saskia M.K. Schnabl - , Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)
  • Ulrich Kneser - , Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)
  • Mareike Leffler - , Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)
  • Raymund E. Horch - , Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)

Abstract

Background: Although multiple strategies for autologous breast reconstruction exist, a vertical midline scar in the abdominal wall as a result of previous laparatomy or abdominoplasty represents a major surgical challenge. To date, little research has been conducted on the regeneration potential of the abdominal wall's superficial vascular, perforator and choke vessel system after surgery using a vertical approache. Methods: We present the cases of 8 patients, of whom 7 underwent autologous breast reconstruction. One patient received a thigh reconstruction. All patients had a vertical abdominal midline scar as a result of a previous surgical intervention. In 3 of the 7 patients, the breast was reconstructed using an MS-2-vertical rectus abdominis myocutaneous (VRAM) free flap. In 4 of these patients, an MS-2-transverse rectus abdominis myocutaneous (TRAM) free flap was performed. The thigh reconstruction used a transverse deep inferior epigastric perforator (DIEP) free flap. Clinical follow- up was done 12 months after operation. Results: All 3 patients who received an MS-2-VRAM had good aesthetic results. Vertical midline scars had no negative effect on surgical outcomes, perfusion and tissue viability of the 4 MS-2-TRAM and transverse DIEP free flaps. Conclusion: These clinical findings indicate that the regeneration potential of the abdominal wall's superficial vascular system in the presence of vertical surgical scars has been greatly underestimated. Use of MS-2-VRAM free flaps in patients with vertical abdominal scars seems to be a suitable and successful alternative in the reconstruction algorithm.

Details

OriginalspracheEnglisch
Seiten (von - bis)137-142
Seitenumfang6
FachzeitschriftCanadian journal of surgery : CJS
Jahrgang53
Ausgabenummer2
PublikationsstatusVeröffentlicht - Apr. 2010
Peer-Review-StatusJa
Extern publiziertJa

Externe IDs

ORCID /0000-0003-4633-2695/work/145698734

Schlagworte

ASJC Scopus Sachgebiete